Osler's node
| Osler's node | |
|---|---|
 | |
| Osler's lesions found on the hand and fingers of a 43-year-old male with subacute bacterial endocarditis | |
| Differential diagnosis | infective endocarditis |
Osler's nodes are painful, red, raised lesions found on the hands and feet. They are associated with a number of conditions, including infective endocarditis, and are caused by immune complex deposition. Their presence is one definition of Osler's sign.[1]
Causes
[edit]Osler's nodes result from the deposition of immune complexes.[2] The resulting inflammatory response leads to swelling, redness, and pain that characterize these lesions.
The nodes are commonly indicative of subacute bacterial endocarditis.[3] 10–25% of endocarditis patients will have Osler's nodes.[4] Other signs of endocarditis include Roth's spots and Janeway lesions. The latter, which also occur on the palms and soles, can be differentiated from Osler's nodes because they are non-tender.[2]
Osler's nodes can also be seen in
- Systemic lupus erythematosus
- Marantic endocarditis
- Disseminated gonococcal infection
- Distal to infected arterial catheter
Etymology
[edit]Osler's nodes are named after Sir William Osler who described them in the early twentieth century.[5][6] He described them as "ephemeral spots of a painful nodular erythema, chiefly in the skin of the hands and feet."[7]
References
[edit]- ^ "Osler sign" at Dorland's Medical Dictionary
- ^ a b Farrior, JB; Silverman, ME (August 1976). "A consideration of the differences between a Janeway's lesion and an Osler's node in infectious endocarditis" (PDF). Chest. 70 (2): 239–43. doi:10.1378/chest.70.2.239. PMID 947688.
- ^ "Osler nodes" at Dorland's Medical Dictionary
- ^ "Endocarditis". The Lecturio Medical Concept Library. Retrieved 19 July 2021.
- ^ synd/1702 at Who Named It?
- ^ Osler, W (1908–1909). "Chronic infectious endocarditis". Quarterly Journal of Medicine. 2. Oxford: 219–230.
- ^ Parashar K, Daveluy S. "Osler's Node and Janeway Lesions". National Center for Biotechnology Information, U.S. National Library of Medicine. Retrieved 19 July 2021.